Female pattern hair loss (FPHL) is a common cause of hair loss and is associated with a reduction in quality of life and psychological morbidity. It is characterised by nonscarring progressive thinning of hair with gradual reduction in the number of hairs, with prevalence increasing with advancing age. A differential diagnosis of FPHL includes conditions such as chronic telogen effluvium, diffuse alopecia areata and some cases of scarring alopecia such as frontal fibrosing alopecia. A comprehensive history and thorough clinical examination are essential in establishing the diagnosis of FPHL.
Additionally, dermoscopy is a valuable tool for appropriate diagnosis, specifically in the early stages of the disease. Due to the chronic course and progressive nature of FPHL, long-term management is essential for sustained effects. Medical treatment with minoxidil remains the mainstay treatment for FPHL. Other therapeutic modalities include topical therapies such as biomimetic peptides, systemic therapies such as oral anti-androgen drugs such as finasteride and spironolactone as well as oral minoxidil in selected cases. Dermatosurgical procedures such as platelet-rich plasma, microneedling, low-level laser and hair transplantation have been used. The role of diet has also been debated. The current article provides an overview on the optimal use of topical minoxidil for the management of FPHL in Indian clinical practice.